Dislocated Shoulder: Procedures For Correction And Home Care…

› [Dislocated Shoulder]
A dislocation of the shoulder can damage surrounding muscles, nerves and blood vessels...

A dislocated shoulder is not only painful but, due to the wide range of motion in the shoulder joint, it can cause permanent damage to surrounding tissues, nerves, and blood vessels if not treated immediately and properly…

The possibility of Brachial Plexus and Axillary nerve injury (refer to the illustrations) increases with people who are over fifty years of age…

Or, if the injury is more than 12 hours old…

The deltoid muscles, tendons, and ligaments, that are arranged near the humeral head also are in danger of tearing with the advent of a dislocated shoulder…

It is not recommended that the lay person attempt to reset this injury independently of professional assistance unless you are in a dire circumstance, such as having the injury occur out in a remote region where medical assistance is more than 12 hours away…

Reduction Or Surgery...?

Reduction, or in other words, the manual setting of the surrounding muscle groups and replacement of the humeral head into the glenoid cavity is typically the procedure, unless surgical intervention is pursuedffg…

Manual reduction of the dislocated shoulder is a common treatment protocol, unless the patient is an athlete or younger person, in this case, surgery is often recommended to reduce the injury and restore the shoulder to full strength with as little damage inflicted upon the joint as possible…

Shoulder surgery is more likely to preserve the shoulder over manual reduction...

 This allows the person to return to sporting activity, or the lifestyle of the younger person, quickly and without complication…

This is the typical thinking of the medical community, so, if you sustain a dislocated shoulder and you are an older person or a non-athlete, you might also like to know that surgical intervention is going to leave your shoulder in better shape, and you may want to insist on, go privately and pay for surgical correction instead of manual reduction…

Surgical intervention is usually recommended in the case of younger people…

As I had mentioned before, the way the medical community looks at this is that a younger person’s shoulder will need to be fully useful to them for many more years, but I will say this: I am in my fifties and if I come up with  a dislocated shoulder now or at anytime, it will be my choice to opt for surgery as the quality of my life now is as important to me as it was when I was younger; probably even more so now.

Providing you take care of yourself, life doesn’t stop at age 35, 40 or 54 as far as I can tell. In my own case, I am probably now more disciplined in the gym than I was in my younger years, and, I also know people who are 20 years my senior who do high impact aerobics three times a week. What we all have in common is that we all need our shoulders to function free of joint pain as much as any athlete or youngster…

So, if you come up with a case of dislocated shoulder, don’t let anyone sell you short by telling you that you don’t need surgery, manual reduction is the way to go for you; this is not necessarily true if you want to stay free of shoulder pain...

Anterior Or Posterior
Shoulder Dislocation...?

In most cases the shoulder will be dislocated into an anterior (forward/front) malposition, with the arm rotated toward the centre of the body (the thumb will point inward)...

Shoulders dislocate primarily into an anterior (forward) malposition. This is usually sustained from a fall with the hand outstretched; most of my patient experience with these has come from a fall from a horse, or the aftermath of a sloppy game of rugby where I was a first responder…

The shoulder can also dislocate posteriorly (to the back of the body) but this is only in rare cases. The cause of this can be electric shock, a car crash, or in some circumstances, if the person is very elderly and frail and the components of the shoulder are so worn away that there is no stability…

In Home Care Of
A Dislocated Shoulder Post
Surgery Or Reduction...

If your shoulder has lost strength and stability due to rheumatoid, Osteo -arthritis, or former injury, it’s a good idea to give it some additional stability through supplementation to re-build the cartilaginous tissues, and using sports tape to add strength to the shoulder. That way there is less of a chance of traumatic injury should you take a spill and fall over accidentally…

Pain relief and home treatment will involve, rest, ice, compression, correct ergonomic positioning, and pre-scribed movement in stages to promote healing…

REST:

Anyone who has suffered traumatic shock will need sleep and additional rest. This is for two specific reasons being 1) rest promotes healing of bones, cartilage, tendons and ligaments and muscles that may have gotten torn during a shoulder dislocation – and most of us know this…

2) The second reason is probably a lesser known fact that when you sustain a traumatic injury, a set of fight or flight/stress hormones such as adrenalin (epinephrine), norepinephrine and Cortisol all get fired off in a major way. If you have ever been in an accident such as in a car, or through sport, you may come to realize at some point that you don’t really remember the pain, or that it hurt like Hell but everything turned kind of surreal in nature, or you may not remember much at all. This is your fight or flight getting hormones getting switched on in such a major way that your brain shuts down. It is a defence mechanism we all have, yet it expresses slightly differently in each of us…

The upshot of this is that trauma induced hormonal fallout needs to a chance to wash back out of your system; and once again, this cleansing process, and the time required for the body to restore levels back to normal is different for each of us…

It is dependent on how we are made up chemically, and there is even evidence to support that blood type has something to do with how fast you will clear your own home grown pharmaceuticals out…

According to Dr. Peter D’Adamo’s research in blood type, type A and AB types will take a longer time to lower Cortisol levels than type O and B people who wash stress hormones, such as Cortisol out through the liver more quickly…

ICE:

10 minutes every two hours....

I recommend you purchase soft, comfortable gel packs, unless you are an athlete and are accustomed to the hard core crushed ice in a plastic bag on a wet flannel routine…

COMPRESSION: 

Sports tape or bandages that are built specifically for shoulder are useful, studies have shown that slings are not, but I would guess this is because they support the weight of the lower arm and not the shoulder itself…

The surrounding tissues of the shoulder require compression to add stability which promotes healing…

ELEVATION/ERGONOMIC BALANCE:

Elevation in the shoulder itself here is not the issue, but balancing the forearm so that the shoulder is in a comfortable non-weight bearing position is, unless you have adequate shoulder strapping which supports the muscle, tendon, and ligamentous tissue – this is dependent on the stage of healing your shoulder is in…

*Newer injuries: keep the weight of the forearm minimized …

*Older injuries: allow for the forearm to bear weight but add extra strength to the shoulder through strapping or taping…

Summarizing…

The information and healing strategies listed here are geared to make you aware of available treatment and home care of your dislocated shoulder and provide a guideline to achieve optimal preservation of your shoulder joint …

Remember that the shoulder is the most mobile joint in the body, and with that comes the price of vulnerability to the area, and therefore a heightened probability of injury…

 The shoulder also receives a lesser blood supply than other joints in the body, which on one hand makes sense because having a huge blood flow go to such a vulnerable area would make us much more likely to lose our lives in any kind of fight, for example…

Injury can be sustained to the shoulder without a huge fear of blood loss or internal bleeding, but at the same time, this attribute slows the healing process and lengthens your recovery time…

Regular home care applying the R.I.C.E. method (mentioned above) will maximize recovery and assist in helping you to re-strengthen and rebalance your shoulder after the dislocation has been set properly and surrounding tissues and blood vessels have had time to heal sufficiently…

› [Dislocated Shoulder]

Disclaimer – This is information on joint pain. I teach, but I do not diagnose, prescibe or treat people who contact me. You are responsible for your condition using your own best judgement combined with what you have learned. Just a heads up - bodies carry unusual differences from time to time, in saying that, you could be one of those rare and unusual beings; if you are in doubt, please contact a physician in your area, so you can rule it out.

Move Freely and Knowledgeably and Be Well!

Dr. Jo

P.S...    “Greater certainty of your condition alone can be a powerful form of pain relief.”